<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".13" citation="COMAR 10.07.02.13" title_num="10" subtitle_num="07" chapter_num="02" heading="Resident Care Policies.">
  <paragraph num="A.">
    <text>A nursing home shall develop written policies consistent with Regulation .11 of this chapter pertaining to:</text>
    <paragraph num="(1)">
      <text>Physician services;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Residents’ rights;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Nursing services;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Dietetic services;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Specialized rehabilitative services including occupational therapy, physical therapy, speech pathology and audiology services;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Pharmaceutical services;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Laboratory and radiologic services;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Dental services;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Social services;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Resident activities;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Clinical records;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Reports and action required in unusual circumstances;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Utilization review;</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Infection control;</text>
    </paragraph>
    <paragraph num="(15)">
      <text>Tuberculosis surveillance;</text>
    </paragraph>
    <paragraph num="(16)">
      <text>Disaster plan;</text>
    </paragraph>
    <paragraph num="(17)">
      <text>Housekeeping services, pest control, and laundry; and</text>
    </paragraph>
    <paragraph num="(18)">
      <text>Resident care management.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Resident Care Policy.</text>
    <paragraph num="(1)">
      <text>A nursing home shall develop resident care policies with the advice of:</text>
      <paragraph num="(a)">
        <text>The principal physician or medical staff or medical director, if applicable; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>At least one registered nurse.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A group of professional personnel including one or more physicians and one or more registered nurses shall review the policies at least annually.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Written policies shall be kept current with the policies used to administer the nursing home.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>For reference purposes, copies of the resident care policies shall be readily available to all personnel responsible for resident care.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The nursing home shall make its resident care policies available for review by residents, the resident’s representative, and the ombudsman.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Policies and Procedures.</text>
    <paragraph num="(1)">
      <text>Upon the request of the Secretary or the Secretary's designee, the facility's policies and procedures shall be made available to the Secretary for onsite review.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The licensee shall submit to the Department any significant substantive changes to the policies and procedures which have occurred since review of the policies and procedures within 2 weeks of implementation of the changes.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Use of Protective Device or Devices.</text>
    <paragraph num="(1)">
      <text>A written physician's order is required for the use of a protective device or devices. This order shall be in effect for a maximum of 60 days. If continuation of the use of a protective device or devices beyond 60 days is necessary, a new order shall be written by the physician and rewritten every 60 days.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The physician's order shall contain the specific type of protective device or devices to be used.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The physician's order shall reflect his or her reason for ordering a protective device or devices.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A resident in a protective device or devices shall be observed periodically by personnel, to ensure that the resident’s health and personal care needs are met.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>A resident who is in a protective device or devices may not be left in the same postural position for more than 2 consecutive hours.</text>
    </paragraph>
  </paragraph>
</regulation>